Antidepressants Blog

Fringe benefits which come unasked as a result of these relaxing mental exercises. These were matters that were easy to discuss and record—better sleep; greater ease at work; less tension in the home; better sexual response; and improved responses, both mental and physical, in many other aspects of our life.

But there is something else, something much more elusive, something much more significant. I have experienced it. I also know that others have experienced it, although they have rarely told me so.

You may easily think to yourself, “Well, how does he know?” I know in the same way as you will know when it comes to you.

When I was asking him about the nature of meditation, the yogi saint of Katmandu told me, “You can show a child a banana, but you cannot tell him how it tastes.” Taste the flavour of your relaxing mental exercises. Taste it deeply. And you will know what I mean. This that is greater than all the rest.

I have tried to write as if I were talking with you in my consulting room. If you were here with me, I would ask you to drop me a note just to let me know how things have gone with you.

As a doctor I want to know the result of my treatment. If the treatment is not quite orthodox, it is all the more important that we know the result. Please, if you have had help from this let me know. What was your trouble? How long had you had it? Then these ideas can be put to others with the additional weight of your own experience.

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On the whole, these deformations consist of localised flattenings and bulgings of the margin of the pupil. In this case one should note whether these distortions appear in the right or left eye, and whether they are found in the upper, lower, nasal or temporal sectors. A sunken condition of a flattened segment leads to inward bulging, corresponding to an increase of all symptoms.

All asymmetrical deformations of the pupil are reliable indications for assessing the condition of the nervous system, as well as to imply a disease condition of those organs whose areas are localised in the sector corresponding to the flattened segment. This second point is very important.

Flattening of the left pupil margin in the upper sector indicates psychic disturbances. Flattening of the lower sector of both pupils indicates severe muscle weakness affecting the legs.

Flattening of the pupil margin in the nasal sector indicates disturbance arising from the spinal cord and its nerve trunks, and includes physical and mental conditions. Temporal flattening corresponds more with hormone disturbances. From cerebellum to gonads, including suprarenale, pancreas and heart, these organs stand in close hormonal relationship. From this arises the clinical picture of vegetative dystony.

Flattening of the pupil margin in the upper sector of the right iris is more often seen in conditions associated with hysteria, whereas involvement of the same sector of the left iris indicates a predominance of melancholic states (see also right iris: Uterus-Cerebellum line, and left iris: Rectum-Cerebellum line).

Right temporal sector flattening suggests disturbance of the liver and consequent effects. In this case, the patients are suffering from liver encumbrance arising from hereditary preconditions caused by faulty nutrition and mode of life

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There are two drugs that doctors at St Thomas’ Hospital are using to cut back the amount of prolactin their patients produce during the last half of the month. One is Vitamin B6, or pyridoxine, which they estimate helps nearly sixty per cent of patients whose symptoms are depression, headaches or breast swelling (at the time of going to press the results of a properly controlled trial of pyridoxine has not yet been published). This vitamin had already been used successfully to treat some women on the Pill who developed depression and headaches. Taking the Pill can sometimes cause a shortage of Vitamin B6 and when this happens, your brain can’t make enough of a substance called 5-hydroxy-tryptamine, and when that happens you get depressed. Some doctors treat the depression by giving their patients more Vitamin B6. Others, who seem to me to have rather more sense, advise their patients that the Pill doesn’t suit them and persuade them to try some other form of contraception that doesn’t have side-effects. A leaflet on Vitamin B6 treatment can be obtained by sending a stamped, addressed envelope to PMT Clinic, Gynaecology Department, St Thomas’ Hospital, Lambeth Palace Road, London SE1. Pyridoxine is obtainable off prescription (as ‘Comploment’, which contains 100 mg of pyridoxine) but as the daily starting dose used at St Thomas’ is considerably lower it is obviously sensible to follow the recommendations given in this leaflet, if you decide to try it for yourself.

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Few of us who drive stop to think what sort of state we are in before we get behind the wheel. Yet driving demands intense concentration and very quick reactions and these are just the qualities that will be most impaired by being off-balance. So let someone else drive if you can, or make your excursion at a later date. But if that’s not possible and you have to drive because you have absolutely no option, make a point of driving more slowly than you normally would. And whenever you stop at traffic lights or junctions, check that you are as relaxed as you can be. Drop those shoulders, relax your feet, don’t grip the wheel so hard and smooth out the wrinkles in your face. It might intrigue the man in the car alongside you, but it won’t hurt him and it could do you a lot of good. Try to take a break every fifty miles or so and have a rest and something to eat and drink. In fact, treat yourself and your car with great care and caution. And remember the golden rule of the road. When in doubt, don’t! This applies particularly to drinking. At any time of the month it’s stupid to drink and drive and we all know that. But just before a period would be the very worst time to run such a risk, because it takes far less alcohol then to make you drunk. And on top of that, your judgement isn’t all that it should be so you might not recognize the warning signals that drink is beginning to affect you until it’s dangerously too late.

Whatever you are doing, practise relaxation as frequently as you can; it is doubly helpful to women who are off-balance. Firstly it will allow your-body to produce the hormones it really needs to get you back on form again. And secondly it can give you the physical means to slow yourself down when you’re rushing and you know it’s dangerous. It really does help if you can do the more hazardous and tricky jobs more slowly than you normally would. Of course, it’s better still if you can hand them over to someone else. But for most of us life doesn’t provide help like this and we have to get on with things as well as we can. So if there’s no one else around, remember to relax and breathe in a lower gear so as to slow yourself up, then take plenty of time over what you’re doing.

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Signs and symptoms

The vomiting itself is obvious, and the doctor concentrates on identifying its cause. It’s also important to evaluate the degree of dehydration caused by persistent vomiting.

Home care

If your child is vomiting, avoid giving solid foods, milk, or aspirin tablets. These substances aggravate the vomiting. Allow the child sips of cold, clear liquids (ice water, carbonated beverages, tea with sugar, flavored gelatin water, commercial mineral and electrolyte solutions, or apple juice). Commercial preparations of orthophosphoric acid, fructose, and glucose also may be given. If the child can keep down a teaspoon of liquid every five minutes, he or she will retain 60 grams of fluid in an hour.

Precautions

• Watch for signs of dehydration in your child.

• If vomiting and diarrhea are happening at the same time, control the vomiting first, then treat the diarrhea.

• Some phenothiazine drugs that are used to control vomiting in adults may cause serious central nervous system side effects in children; do not use them for children.

• Remember that abdominal pain (with or without vomiting) could be appendicitis.

Medical treatment

Your doctor will determine the cause of the vomiting by obtaining a detailed health history and performing a careful physical and neurological examination. The presence and degree of dehydration will be assessed, and if the child is seriously dehydrated he or she will be hospitalized for administration of intravenous fluids.

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One day it will be possible to prevent diabetes. Unfortunately at the time of writing this, it is not possible to do so. We are confident that diabetes will be preventable because we know enough about the development of diabetes to direct research towards prevention and there are hopeful discoveries in this field.

We know that some people inherit an increased risk of diabetes, and we can identify these people by a blood test. We know that in most people, diabetes takes months or years to develop and during this period there is a gradual process of damage leading to the loss of the vital islet cells needed to make insulin. We can recognize that this process is going on by finding the evidence of it in the blood. This is done by detecting the presence of islet cell and insulin antibodies.

We know the process of damage is a self-destructive process called an auto-immune reaction and we have drugs that can slow down or even halt the auto-immune reactions in the body. There seems no doubt that more effective drugs that will control the process safely will be developed in the future.

It may moreover be possible one day to protect the islet ceils from self-destruction by a process perhaps similar to immunization. Major research laboratories and groups in many centers are actively working in this exciting area of diabetes.

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Matters such as high interest rates, an impossible boss at work, a drunken husband, an unexpected pregnancy, trouble with the tax authorities, children on drugs, caught .05 and awaiting trial, an unfaithful spouse, sick children, or chronic illness of oneself, are not stress.

Stress is the disparity between the problem and the person’s ability to cope with it. So for some women an unfaithful husband is no stress at all; whilst for others it is a devastating stress.

Physiologically, stress is the disharmony of brain function which arises when more impulses are arriving in our brain from our problems than can be properly integrated.

The disharmony of brain function produces an over-alertness of nerve cells which is manifested as anxiety.

Anxiety produces nervous tension with various psychoneurotic and psychosomatic symptoms.

Obvious conditions are palpitations, butterflies in the stomach, shakiness, sweating and stiffness in muscles.

Less obvious conditions are asthma, ulcers and many cases of high blood pressure.

Stress is often fired off by some major problem. But the major problem always operates on a background of minor and incidental problems.

So a woman who has been able to cope with a sick child all day may suffer stress if her husband comes home and blows up because he has had a bad day at work. The two things together may be too much for her coping ability. On the other hand, if he gives his wife some help, all is well.

Then, of course, there are many long-acting problems— a child, not sick, but always wanting to avoid school; the children having friends who are taking drugs; poor communication in the marriage. Not big things in themselves, but they can add up and so cause stress.

The disturbing nervous impulses from different problems are cumulative, so that a reduction of nervous impulses from one problem may mean that the impulses from the major problem do not reach sufficient intensity to produce stress.

Most of our problems cannot be avoided or ameliorated. So how do we avoid stress?

We can make a second-class journey through life on tranquillizers. Tranquillizers work by dulling the activity of nerve cells; reducing our alertness, ability to think, and perception of the full beauty around us.

Or we can also avoid stress by trying to minimize our tasks and problems. Avoid trouble. Get an easy job. Avoid responsibility. Avoid active competition. Retreat from the active hurly-burly of life. Become a vegetable.

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Stress upsets the smooth working of our body, and also spoils the quality of life. Yet I am frequently asked, ‘Is some degree of stress good for us?’ ‘Surely a little bit of stress is good for people?’

No. I don’t think so. I know it’s a common belief amongst many people, and even amongst many psychiatrists, that some stress is good for us; but stress is not good for us, because it is essentially a disordered function of the mind.

We want to be careful what we mean by stress. Different people have different ideas about what stress is. Some people just regard it as the problem, or the hurdle, or the difficulty that the person is confronted with. However, this is only one side of stress. I see it as the disparity between the problem and the person’s ability to cope with it: it is the gap between something difficult, or even frightening, and our ability to grapple with it. So one person faced with a problem may be under stress, while another person faced with the same problem may be under no stress at all.

If we are living really well, if we are well adjusted to life, we are coping with difficult situations without stress: the quality of life is good, and we deal with problems without anxiety, apprehension, or depression.

Quality of life – what is it?

‘Quality of life’ has become a catch-phrase. It sounds well from psychologists, it gets a few votes for politicians, and it is used by all manner of do-gooders.

But what is the Quality of Life?

Some years ago I had a large room with sixty comfortable chairs, which I called the Quiet Place because it was there that I showed people how to meditate. It was there, too, in the Quiet Place, that I held a series of public meetings to discuss the quality of life.

Now, what is the quality of life? People brought up all sorts of ideas. Is it a highbrow conversation? Is it looking at modern works of art? Is it a reasonable standard of living? Or is it nothing to worry about? Is it simply enjoying nature? Does it have something to do with God?

For many years I have felt that an important part of quality of life is inner peace of mind and the absence of tension, anxiety and stress. Life is better if we are free of tensions, and the quality of life is enhanced. However, I am not suggesting that ease of mind is quality of life in itself, but I do think that the development of ease of mind is a large step towards quality of life. And the important thing is this: it is a step that is within our grasp.

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«It seems silly. It just comes on me when I have to do something important. At a time when I want it least of all. An exam or something like that. Just before the event. I have to excuse myself, and rush off to the toilet with nervous diarrhea. »

We have just discussed the way in which longstanding stress may cause chronic constipation. At first it may seem strange that stress is also the cause of nervous diarrhea. It comes about like this. Stress activates the sympathetic nervous system which inhibits movement of the bowel so that we will be free for action. But all these reactions are governed by self-regulating mechanisms. The self-regulating mechanism may overreact. This is what happens in nervous diarrhea. The parasympathetic nervous system has the opposite effect of the sympathetic. It increases movement of the bowel. In order to neutralize too great sympathetic activity, the self-regulating mechanism may activate the antagonistic, parasympathetic system. The result is an increase in the contractions of the bowel which results in diarrhea.

Nervous diarrhea of this nature can be relieved by reducing the level of stress by simple meditation. The object is to reduce the severity of stress in life as a whole, and not wait for the advent of some demanding situation.

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What is it?

Pain in the abdomen caused by the spasm of a hollow abdominal organ.

Colic can thus occur in the urinary passages, the uterus or the intestine, for example. The term is not often used of adult pains by lay people but is usually confined to the irritable crying of babies and young children thought to be caused by such muscle spasm.

Three-month colic is a condition so called because it consists of colicky pains (in babies) that disappear by 3 months of age. It is usually worst in the evening. Many babies with so-called colic do not have abdominal organ spasm at all-they are crying for another reason.

What causes it?

Given that the very word ‘colic’ is used so widely and indiscriminately of crying children it is essential to look at what the causes really are if one is to try to prevent any of them.

• Bottle-fed babies who are fed with a teat that has too large a hole in it can gulp down air and so get abdominal pains as the intestine passes this gas along.

• In breastfeeding mothers with a very large and fast flow of milk much the same can happen.

• Often it appears that so-called colic is not colic as such but is a response to the mother’s busyness and preoccupation with other things, rather than the baby, at the time of the day typical for ‘colic’ (6 o’clock in the evening). Some of these irritable babies may simply want attention.

• A considerable number of so-called ‘colicky’ babies are mislabeled-they are really bored, lonely or hungry.

• Recent research has found that traces of undigested foods and drinks get through into the mother’s bloodstream and thus in her milk. These proteins (mainly from cows’ milk) then upset certain susceptible babies and produce colic.

• Other foods a mother eats to which neither she nor her baby are actually ‘allergic’ can also produce colic. Onions, garlic, Chinese food, cabbage, beans, green leafy vegetables and alcohol can all be culprits. Green leafy vegetables and pulses can make a breast-fed baby very windy.

• A poor breast milk supply, for whatever reason, can produce a baby who is always hungry and cries. He is labeled colicky.

• Cows’ milk causes colic in some allergic, bottle-fed babies.

• Some teething babies suffer from ‘colic’ too.

Prevention

• Change the teat on the bottle to one with a smaller hole. Feed more slowly and ‘wind’ the baby before lying him or her down.

• If a breastfeeding mother has too much milk she can express the first milk by hand and either keep it to give to a breast-milk bank at her local hospital or discard it. The other way of overcoming the problem of too much milk is to feed from one breast only at a feed. Alternate the one you use. Allow the baby to suck at the empty breast for comfort. In this way he or she gets milk and comfort sucking and yet not too much milk. Express the unused breast if it becomes uncomfortable.

• Relax at the end of the day as much as possible. Spread out household chores through the day and pre-prepare the evening meal, for example. Try to sit down and perhaps have a small drink of alcohol to relax yourself.

• Ensure that your baby is not bored, is played with and gets plenty of stimulation and stays with you wherever you are, whether he or she is awake or asleep.

• If you are breastfeeding try cutting out cows’ milk and milk products entirely from your diet for two weeks and see if this does anything to your baby’s colic. If things improve, stay off dairy products until you wean and then don’t give them to your baby.

• If you are breastfeeding, keep off foods you find from experience give your child colic.

• If you have a poor milk supply, feed more frequently day and night and never let your baby go more than three hours without a feed-if necessary wake him or her up and feed.

• If cows’ milk is the culprit in your baby’s bottle use goats’ milk or soya milk instead.

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